Hello Dr. Barchas,
Two years ago I adopted a now 6-year-old non-neutered English Bull mastiff (127 lbs) that has been dealing with loose stool for the last month. This started with slimy poop, so I took him to the vet immediately. He put him on a boiled chicken breast and rice diet and Flagyl 500mg (1.5 tab twice a day). This hardened the stool, but after 10 days of treatment on Flagyl, the slimy poop came back.
The vet suggested I continue treatment with antibiotics because my dog is acting otherwise normally. The pharmacy filled the prescription with Metronidazole 500mg (1.5 to two times a day). After 7 days of treatment, his stool did not show significant hardening and he had an orangish bowel movement. I took my dog back to the vet and asked for a Flagyl refill. He also put him on Sucralfate 1 GM every 12 hours, three fiber capsules a day and Pepcid AC 20mg every 12 hours, adding a special gastrointestinal health soft dog food.
After a week and five days of this treatment, he is showing not a significant change in poop hardening. Yesterday the orangish bowel movement returned. This morning it was brown again.
I should note my dog is still acting normally (thank god) and still on boiled chicken breast and rice with gastrointestinal health soft dog food. He is always hungry. He did not lose any weight between vet visits. He is on Sentinel.
I am lost. I am a single dog mom and money is running out fast! His medication will be ending this week, and I need help on how to proceed. What could this be?
Chronic (or, in your dog’s case, semi-chronic) diarrhea has many possible causes. Some, such as intestinal worms and microscopic parasites, are easy to diagnose and treat. Others such as inflammatory bowel disease (also known as infiltrative bowel disease or simply IBD), food intolerance, metabolic disorders, and a digestive problem called exocrine pancreatic insufficiency usually are diagnosed with more advanced (and expensive) testing.
Naturally, the best thing would be comprehensive blood work and diagnostic imaging (X-rays and ultrasound) to get a better handle on the situation. But since funds are limited and your dog feels fine (and isn’t losing weight), it’s not unreasonable to try a more conservative approach.
Your dog’s monthly Sentinel should keep him free from most intestinal worms, but I’d still recommend a stool test to check for microscopic parasites. If that test comes up negative, you may want to consider a diet change.
Since you haven’t seen a good response to an easily digestible diet, you may want to try a limited ingredient diet next. These diets typically have unusual sources of protein (fish or venison and potato, duck and green pea). Dogs with IBD or food intolerance often react to proteins, so you may see some improvement after several weeks on a new food. The bad news about such diets is that they are much more affordable for Chihuahuas than for Mastiffs.
If a diet change doesn’t do the trick, you may want to consider adding supplemental pancreatic enzymes to your dog’s food to help digestion in cases of exocrine pancreatic insufficiency.
Sadly, there is a chance that neither a new diet nor enzymes will permanently address the problem. In that case, you may have no recourse other than comprehensive testing. No matter what, I recommend that you try not to go down the path of lifelong daily medications for your boy. Metronidazole, Pepcid, and sucralfate are unlikely to cause harm with short-term use, but in the long run I feel the other options I’ve mentioned are better.
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